Search results for: spending plan

Authors: Onur Ozveri, Korkut Karabag, Cagri Keles

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It is an important issue that the occurring of production downtime and repair costs when machines fail in the machine intensive production industries. In the case of failure of more than one machine at the same time, which machines will have the priority to repair, how to determine the optimal repair time should be allotted for this machines and how to plan the resources needed to repair are the key issues. In recent years, Business Process Management (BPM) technique, bring effective solutions to different problems in business. The main feature of this technique is that it can improve the way the job done by examining in detail the works of interest. In the industries, maintenance and repair works are operating as a process and when a breakdown occurs, it is known that the repair work is carried out in a series of process. Maintenance main-process and repair sub-process are evaluated with process management technique, so it is thought that structure could bring a solution. For this reason, in an international manufacturing company, this issue discussed and has tried to develop a proposal for a solution. The purpose of this study is the implementation of maintenance and repair works which is integrated with process management technique and at the end of implementation, analyzing the maintenance related parameters like quality, cost, time, safety and spare part. The international firm that carried out the application operates in a free region in Turkey and its core business area is producing original equipment technologies, vehicle electrical construction, electronics, safety and thermal systems for the world's leading light and heavy vehicle manufacturers. In the firm primarily, a project team has been established. The team dealt with the current maintenance process again, and it has been revised again by the process management techniques. Repair process which is sub-process of maintenance process has been discussed again. In the improved processes, the ABC equipment classification technique was used to decide which machine or machines will be given priority in case of failure. This technique is a prioritization method of malfunctioned machine based on the effect of the production, product quality, maintenance costs and job security. Improved maintenance and repair processes have been implemented in the company for three months, and the obtained data were compared with the previous year data. In conclusion, breakdown maintenance was found to occur in a shorter time, with lower cost and lower spare parts inventory.

Keywords: ABC equipment classification, business process management (BPM), maintenance, repair performance

Procedia PDF Downloads 194

Authors: Paolo Guzzini, Emad Samuel M. Ebeid

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Bridges and Railways are critical infrastructures. Ensuring safety for transports using such assets is a primary goal as it directly impacts the lives of people. By the way, improving safety could require increased investments in O&M, and therefore optimizing resource usage for asset maintenance becomes crucial. Drones4Safety (D4S), a European project funded under the H2020 Research and Innovation Action (RIA) program, aims to increase the safety of the European civil transport by building a system that relies on 3 main pillars: • Drones operating autonomously in swarm mode; • Drones able to recharge themselves using inductive phenomena produced by transmission lines in the nearby of bridges and railways assets to be inspected; • Data acquired that are analyzed with AI-empowered algorithms for defect detection This paper describes the business model behind this disruptive project. The Business Model is structured in 2 parts: • The first part is focused on the design of the business model Canvas, to explain the value provided by the Drone4safety project; • The second part aims at defining a detailed financial analysis, with the target of calculating the IRR (Internal Return rate) and the NPV (Net Present Value) of the investment in a 7 years plan (2 years to run the project + 5 years post-implementation). As to the financial analysis 2 different points of view are assumed: • Point of view of the Drones4safety company in charge of designing, producing, and selling the new system; • Point of view of the Utility company that will adopt the new system in its O&M practices; Assuming the point of view of the Drones4safety company 3 scenarios were considered: • Selling the drones > revenues will be produced by the drones’ sales; • Renting the drones > revenues will be produced by the rental of the drones (with a time-based model); • Selling the data acquisition service > revenues will be produced by the sales of pictures acquired by drones; Assuming the point of view of a utility adopting the D4S system, a 4th scenario was analyzed taking into account the decremental costs related to the change of operation and maintenance practices. The paper will show, for both companies, what are the key parameters affecting most of the business model and which are the sustainable scenarios.

Keywords: a swarm of drones, AI, bridges, railways, drones4safety company, utility companies

Procedia PDF Downloads 141

Authors: Fazli Rahim Shinwari, Ulrich Dittmer

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Like many megacities around the world, Kabul is facing severe problems due to the rising frequency of urban flooding. Since 2001, Kabul is experiencing rapid population growth because of the repatriation of refugees and internal migration. Due to unplanned development, green areas inside city and hilly areas within and around the city are converted into new housing towns that had increased runoff. Trenches along the roadside comprise the unplanned drainage network of the city that drains the combined sewer flow. In rainy season overflow occurs, and after streets become dry, the dust particles contaminate the air which is a major cause of air pollution in Kabul city. In this study, a stormwater management model is introduced as a basis for a systematic approach to urban drainage planning in Kabul. For this purpose, Kabul city is delineated into 8 watersheds with the help of one-meter resolution LIDAR DEM. Storm, water management model, is developed for Wazirabad catchment by using available data and literature values. Due to lack of long term metrological data, the model is only run for hourly rainfall data of a rain event that occurred in April 2016. The rain event from 1st to 3rd April with maximum intensity of 3mm/hr caused huge flooding in Wazirabad Catchment of Kabul City. Model-estimated flooding at some points of the catchment as an actual measurement of flooding was not possible; results were compared with information obtained from local people, Kabul Municipality and Capital Region Independent Development Authority. The model helped to identify areas where flooding occurred because of less capacity of drainage system and areas where the main reason for flooding is due to blockage in the drainage canals. The model was used for further analysis to find a sustainable solution to the problem. The option to construct new canals was analyzed, and two new canals were proposed that will reduce the flooding frequency in Wazirabad catchment of Kabul city. By developing the methodology to develop a stormwater management model from digital data and information, the study had fulfilled the primary objective, and similar methodology can be used for other catchments of Kabul city to prepare an emergency and long-term plan for drainage system of Kabul city.

Keywords: urban hydrology, storm water management, modeling, SWMM, GEO-SWMM, GIS, identification of flood vulnerable areas, urban flooding analysis, sustainable urban drainage

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Authors: Nataliya L. Ogurechnikova

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The paper aims to clarify the function of articles in the English speech and specify their place and role in the English language, taking into account the use of articles for delimitation of speech. A focus of the paper is the use of the definite and the indefinite articles with different types of noun phrases which comprise either one noun with or without attributes, such as the King, the Queen, the Lion, the Unicorn, a dimple, a smile, a new language, an unknown dialect, or several nouns with or without attributes, such as the King and Queen of Hearts, the Lion and Unicorn, a dimple or smile, a completely isolated language or dialect. It is stated that the function of delimitation is related to perception: the number of speech units in a text correlates with the way the speaker perceives and segments the denotation. The two following combinations of words the house and garden and the house and the garden contain different numbers of speech units, one and two respectively, and reveal two different perception modes which correspond to the use of the definite article in the examples given. Thus, the function of delimitation is twofold, it is related to perception and cognition, on the one hand, and, on the other hand, to grammar, if the subject of grammar is the structure of speech. Analysis of speech units in the paper is not limited by noun phrases and is amplified by discussion of peripheral phenomena which are nevertheless important because they enable to qualify articles as a syntactic phenomenon whereas they are not infrequently described in terms of noun morphology. With this regard attention is given to the history of linguistic studies, specifically to the description of English articles by Niels Haislund, a disciple of Otto Jespersen. A discrepancy is noted between the initial plan of Jespersen who intended to describe articles as a syntactic phenomenon in ‘A Modern English Grammar on Historical Principles’ and the interpretation of articles in terms of noun morphology, finally given by Haislund. Another issue of the paper is correlation between description and denotation, being a traditional aspect of linguistic studies focused on articles. An overview of relevant studies, given in the paper, goes back to the works of G. Frege, which gave rise to a series of scientific works where the meaning of articles was described within the scope of logical semantics. Correlation between denotation and description is treated in the paper as the meaning of article, i.e. a component in its semantic structure, which differs from the function of delimitation and is similar to the meaning of other quantifiers. The paper further explains why the relation between description and denotation, i.e. the meaning of English article, is irrelevant for noun morphology and has nothing to do with nominal categories of the English language.

Keywords: delimitation of speech, denotation, description, perception, speech units, syntax

Procedia PDF Downloads 241

Authors: Ehsan Moradi, Parisa Paikhaste, Amir Alam Beigi, Seyedeh Somayeh Bathaei

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The need for entrepreneurial sustainability is as important as the entrepreneurship category itself. By transferring competencies in a sustainable entrepreneurship framework, entrepreneurship education can make a significant contribution to the effectiveness of businesses, especially for start-up entrepreneurs. This study analyzes the essential competencies of students in the development of sustainable entrepreneurship. It is an applied causal study in terms of nature and field in terms of data collection. The main purpose of this research project is to study and explain the dimensions of sustainability entrepreneurship competencies among agricultural students. The statistical population consists of 730 junior and senior undergraduate students of the Campus of Agriculture and Natural Resources, University of Tehran. The sample size was determined to be 120 using the Cochran's formula, and the convenience sampling method was used. Face validity, structure validity, and diagnostic methods were used to evaluate the validity of the research tool and Cronbach's alpha and composite reliability to evaluate its reliability. Structural equation modeling (SEM) was used by the confirmatory factor analysis (CFA) method to prepare a measurement model for data processing. The results showed that seven key dimensions play a role in shaping sustainable entrepreneurial development competencies: systems thinking competence (STC), embracing diversity and interdisciplinary (EDI), foresighted thinking (FTC), normative competence (NC), action competence (AC), interpersonal competence (IC), and strategic management competence (SMC). It was found that acquiring skills in SMC by creating the ability to plan to achieve sustainable entrepreneurship in students through the relevant mechanisms can improve entrepreneurship in students by adopting a sustainability attitude. While increasing students' analytical ability in the field of social and environmental needs and challenges and emphasizing curriculum updates, AC should pay more attention to the relationship between the curriculum and its content in the form of entrepreneurship culture promotion programs. In the field of EDI, it was found that the success of entrepreneurs in terms of sustainability and business sustainability of start-up entrepreneurs depends on their interdisciplinary thinking. It was also found that STC plays an important role in explaining the relationship between sustainability and entrepreneurship. Therefore, focusing on these competencies in agricultural education to train start-up entrepreneurs can lead to sustainable entrepreneurship in the agricultural higher education system.

Keywords: sustainable entrepreneurship, entrepreneurship education, competency, agricultural higher education

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Authors: Ceylan Sozer, Ece Ceylan Baba

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The reforms and changes that began with industrialization in cities and continued with globalization in 1980’s, created many changes in urban environments. City centers which are desolated due to industrialization, began to get crowded with globalization and became the heart of technology, commerce and social activities. While the immediate and intense alterations are planned around rigorous visions in developed countries, several urban areas where the processes were underestimated and not taken precaution faced with irrevocable situations. When the effects of the globalization in the cities are examined, it is seen that there are some anticipatory system plans in the cities about the future problems. Several cities such as New York, London and Tokyo have planned to resolve probable future problems in a systematic scheme to decrease possible side effects during globalization. The decisions in urban planning and their applications are the main points in terms of sustainability and livability in such mega-cities. This article examines the effects of globalization on urban planning through 3 mega cities and the applications. When the applications of urban plannings of the three mega-cities are investigated, it is seen that the city plans are generated under light of past experiences and predictions of a certain future. In urban planning, past and present experiences of a city should have been examined and then future projections could be predicted together with current world dynamics by a systematic way. In this study, methods used in urban planning will be discussed and ‘Anticipatory System’ model will be explained and relations with global-urban planning will be discussed. The concept of ‘anticipation’ is a phenomenon that means creating foresights and predictions about the future by combining past, present and future within an action plan. The main distinctive feature that separates anticipatory systems from other systems is the combination of past, present and future and concluding with an act. Urban plans that consist of various parameters and interactions together are identified as ‘live’ and they have systematic integrities. Urban planning with an anticipatory system might be alive and can foresight some ‘side effects’ in design processes. After globalization, cities became more complex and should be designed within an anticipatory system model. These cities can be more livable and can have sustainable urban conditions for today and future.In this study, urban planning of Istanbul city is going to be analyzed with comparisons of New York, Tokyo and London city plans in terms of anticipatory system models. The lack of a system in İstanbul and its side effects will be discussed. When past and present actions in urban planning are approached through an anticipatory system, it can give more accurate and sustainable results in the future.

Keywords: globalization, urban planning, anticipatory system, New York, London, Tokyo, Istanbul

Procedia PDF Downloads 143

Authors: Hailemariam Getachew, John Sandi, Isata Dumbuya, Patricia Efe.Azikiwe, Evaline Nginge, Moses Mugisha, Eseoghene Dase, Foday Mandaray, Grace Moore

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Enhanced recovery after cesarean section (ERAC) is a standardized peri- operative care program that comprises the multidisciplinary team's collective efforts working in collaboration throughout the peri-operative period with the principal goal to improve quality of surgical care, decrease surgical related complications, and increasing patient satisfaction. Objective: The main objective of this project is to improve the implementation of enhanced recovery after cesarean section at Koidu Government hospital. Identified gap: Even though the hospital is providing comprehensive maternal and child care service, there are gaps in the implementation of ERAC. According to our survey, we found that there is low (13.3%) utilization of WHO surgical safety checklist, only limited (15.9%) patients get opioid free analgesia, pain was not recorded as a vital sign, there is no standardized checklist for hand over to and from Post Anesthesia care Unit(PACU). Furthermore, there is inconsistent evidence based post-operative care and there is no local consensus protocol and guideline as well. Implementation plan: we aimed at designing standardized protocol, checklist and guideline, provide training, build staff capacity, document pain as vital sign, perform regional analgesia, and provide evidence based post-operative care, monitoring and evaluation. Result: Data from 389 cesarean mothers showed that, Utilization of the WHO surgical safety check list found to be 95%, and pain assessment and documentation was done for all surgical patients. Oral feeding, ambulation and catheter removal was performed as per the ERAC standard for all patients. Postoperative complications drastically decreased from 13.6% to 8.1%. While, the rate of readmission was kept below 1%. Furthermore, the duration of hospital stay decreased from 4.64 days to 3.12 days. Conclusion The successful implementation of ERAC protocols demonstrates through this Quality Improvement Project that, the effectiveness of the protocols in improving recovery and patient outcome following cesarean section.

Keywords: cesarean delivery, enhanced recovery, quality improvement, patient outcome

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Authors: Vishwanath Mali, Hemant Warhatkar, Raju Pawade

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Drilling of bone has been always challenging for surgeons due to the adverse effect it may impart to bone tissues. Force has to be applied manually by the surgeon while performing conventional bone drilling which may lead to permanent death of bone tissues and nerves. During bone drilling the temperature of the bone tissues increases to higher values above 47 ⁰C that causes thermal osteonecrosis resulting into screw loosening and subsequent implant failures. An attempt has been made here to study the input drilling parameters and surgical drill bit geometry affecting bone health during bone drilling. A One Factor At a Time (OFAT) method is used to plan the experiments. Input drilling parameters studied include spindle speed and feed rate. The drill bit geometry parameter studied include point angle and helix angle. The output variables are drilling thrust force and bone temperature. The experiments were conducted on goat femur bone at room temperature 30 ⁰C. For measurement of thrust forces KISTLER cutting force dynamometer Type 9257BA was used. For continuous data acquisition of temperature NI LabVIEW software was used. Fixture was made on RPT machine for holding the bone specimen while performing drilling operation. Bone specimen were preserved in deep freezer (LABTOP make) under -40 ⁰C. In case of drilling parameters, it is observed that at constant feed rate when spindle speed increases, thrust force as well as temperature decreases and at constant spindle speed when feed rate increases thrust force as well as temperature increases. The effect of drill bit geometry shows that at constant helix angle when point angle increases thrust force as well as temperature increases and at constant point angle when helix angle increase thrust force as well as temperature decreases. Hence it is concluded that as the thrust force increases temperature increases. In case of drilling parameter, the lowest thrust force and temperature i.e. 35.55 N and 36.04 ⁰C respectively were recorded at spindle speed 2000 rpm and feed rate 0.04 mm/rev. In case of drill bit geometry parameter, the lowest thrust force and temperature i.e. 40.81 N and 34 ⁰C respectively were recorded at point angle 70⁰ and helix angle 25⁰ Hence to avoid thermal necrosis of bone it is recommended to use higher spindle speed, lower feed rate, low point angle and high helix angle. The hard nature of cortical bone contributes to a greater rise in temperature whereas a considerable drop in temperature is observed during cancellous bone drilling.

Keywords: bone drilling, helix angle, point angle, thrust force, temperature, thermal necrosis

Procedia PDF Downloads 310

Authors: Noreen Pulte

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Prior to the 'Back to Sleep' Campaign in 1992, 1 of every 300 infants seen by Advanced Practice Providers had plagiocephaly. Insufficient attention is given to plagiocephaly and brachycephaly diagnoses in practice and pediatric education. In this talk, Nurse Practitioners and Pediatric Providers will be able to: (1) identify red flags associated with head shape abnormalities, (2) learn techniques they can teach parents to prevent head shape abnormalities, and (3) differentiate between plagiocephaly, brachycephaly, and craniosynostosis. The presenter is a Primary Care Pediatric Nurse Practitioner at Ann & Robert H. Lurie Children's Hospital of Chicago and the primary provider for its head shape abnormality clinics. She will help participants translate key information obtained from birth history, review of systems, and developmental history to understand risk factors for head shape abnormalities and progression of deformities. Synostotic and non-synostotic head shapes will be explained to help participants differentiate plagiocephaly and brachycephaly from synostotic head shapes. This knowledge is critical for the prompt referral of infants with craniosynostosis for surgical evaluation and correction. Rapid referral for craniosynostosis can possibly direct the patient to a minimally invasive surgical procedure versus a craniectomy. As for plagiocephaly and brachycephaly, this timely referral can also aid in a physical therapy referral if necessitated, which treats torticollis and aids in improving head shape. A well-timed referral to a head shape clinic can possibly eliminate the need for a helmet and/or minimize the time in a helmet. Practitioners will learn the importance of obtaining head measurements using calipers. The presenter will explain head calculations and how the calculations are interpreted to determine the severity of the head shape abnormalities. Severity defines the treatment plan. Participants will learn when to refer patients to a head shape abnormality clinic and techniques they should teach parents to perform while waiting for the referral appointment. The purpose, mechanics, and logistics of helmet therapy, including optimal time to initiate helmet therapy, recommended helmet wear-time, and tips for helmet therapy compliance, will be described. Case scenarios will be incorporated into the presenter's presentation to support learning. The salient points of the case studies will be explained and discussed. Practitioners will be able to immediately translate the knowledge and skills gained in this presentation into their clinical practice.

Keywords: plagiocephaly, brachycephaly, craniosynostosis, red flags

Procedia PDF Downloads 96

Authors: V. L. M. F. Capellini, A. P. P. M. Maturana, N. C. M. Brondino, M. B. C. L. B. M. Peixoto, A. J. Broughton

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A paradigm shift is a process. The process of implementing inclusive education, a system constructed to support all learners, requires planning, identification, experimentation, and evaluation. In this vein, the purpose of the present study was to evaluate the capacity of one Brazilian state school systems to provide special education students with a quality inclusive education. This study originated at the behest of concerned families of students with special needs who filed complaints with the Municipality of Bauru, São Paulo. These families claimed, 1) children with learning differences and educational needs had not been identified for services, and 2) those who had been identified had not received sufficient specialized educational assistance (SEA) in schools across the City of Bauru. Hence, the Office of Civil Rights for the state of São Paulo (Ministério Público de São Paulo) summoned the local higher education institution, UNESP, to design a research study to investigate these allegations. In this exploratory study, descriptive data were gathered from all elementary and middle schools including 58 state schools and 17 city schools, for a total of 75 schools overall. Data collection consisted of each school's annual strategic action plan, surveys and interviews with all school stakeholders to determine their perceptions of the inclusive education available to students with Special Education Needs (SEN). The data were collected as one of four stages in a larger study which also included field observations of a focal students' experience and a continuing education course for all teachers and administrators in both state and city schools. For the purposes of this study, the researchers were interested in understanding the perceptions of school staff, parents, and students across all schools. Therefore, documents and surveys from 75 schools were analyzed for adherence to federal legislation guaranteeing students with SEN the right to special education assistance within the regular school setting. Results shows that while some schools recognized the legal rights of SEN students to receive special education, the plans to actually deliver services were absent. In conclusion, the results of this study revealed both school staff and families have insufficient planning and accessibility resources, and the schools have inadequate infrastructure for full-time support to SEN students, i.e., structures and systems to support the identification of SEN and delivery of services within schools of Bauru, SP. Having identified the areas of need, the city is now prepared to take next steps in the process toward preparing all schools to be inclusive.

Keywords: inclusion, school, special education, special needs

Procedia PDF Downloads 159

Authors: Kamal Kaushik, Dandpani Epili, Ajay G. V., Ashutosh, S. Pradhaan

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Introduction: Radiation therapy has come a long way over a period of decades, from 2-dimensional radiotherapy to intensity-modulated radiation therapy (IMRT) or VMAT. For advanced radiation therapy, we need better patient position reproducibility to deliver precise and quality treatment, which raises the need for better image guidance technologies for precise patient positioning. This study presents a two tattoo simulation with roll correction technique which is comparable to other advanced patient positioning techniques. Objective: This is a site-specific study is aimed to perform a comparison between various treatment positioning techniques used for the treatment of patients of Ca- Breast undergoing radiotherapy. In this study, we are comparing 5 different positioning methods used for the treatment of ca-breast, namely i) Vacloc with 3 tattoos, ii) Breast board with three tattoos, iii) Thermoplastic cast with three fiducials, iv) Breast board with a thermoplastic mask with 3 tattoo, v) Breast board with 2 tattoos – A roll correction method. Methods and material: All in one (AIO) solution immobilization was used in all patient positioning techniques for immobilization. The process of two tattoo simulations includes positioning of the patient with the help of a thoracic-abdomen wedge, armrest & knee rest. After proper patient positioning, we mark two tattoos on the treatment side of the patient. After positioning, place fiducials as per the clinical borders markers (1) sternum notch (lower border of clavicle head) (2) 2 cm below from contralateral breast (3) midline between 1 & 2 markers (4) mid axillary on the same axis of 3 markers (Marker 3 & 4 should be on the same axis). During plan implementation, a roll depth correction is applied as per the anterior and lateral positioning tattoos, followed by the shifts required for the Isocentre position. The shifts are then verified by SSD on the patient surface followed by radiographic verification using Cone Beam Computed Tomography (CBCT). Results: When all the five positioning techniques were compared all together, the produced shifts in Vertical, Longitudinal and lateral directions are as follows. The observations clearly suggest that the Longitudinal average shifts in two tattoo roll correction techniques are less than every other patient positioning technique. Vertical and lateral Shifts are also comparable to other modern positioning techniques. Concluded: The two tattoo simulation with roll correction technique provides us better patient setup with a technique that can be implemented easily in most of the radiotherapy centers across the developing nations where 3D verification techniques are not available along with delivery units as the shifts observed are quite minimal and are comparable to those with Vacloc and modern amenities.

Keywords: Ca. breast, breast board, roll correction technique, CBCT

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Authors: Giovanni Duran Polo

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Demonstrate the importance of the stages such as Information, Diagnosis, Management, and Intervention is fundamental to have a historical, live, and quality inhabited center. One of the major actions to take is to promote the concept of the management of a historic center with harmonious development. For that, concerned actors should strengthen the concept that said historic center may be the neighborhood of all and for all. The centers of historical cities, presented as any other urban area, social, environmental issues etc; yet they get added value that have no other city neighborhoods. The equity component, either by the urban plan, or environmental quality offered properties of architectural, landscape or some land uses are the differentiating element, while the tool that makes them attractive face pressure exerted by new housing developments or shopping centers. That's why through the experience of working in historical centers, they are declared the actions in heritage areas. This paper will show how the encounter with each of these places are trying to take the phases of information, to gather all the data needed to be closer to the territory with specific data, diagnosis; which allowed the actors to see what state they were, felt how the heart is related to the rest of the city, show what problems affected the situation and what potential it had to compete in a global market. Also, to discuss the importance of the organization, as it is legal and normative basis for it have an order and a concept, when you know what can and what cannot, in an area where the citizen has many myth or history, when he wanted to intervene in protected buildings. It is also appropriate to show how it could develop the intervention phase, where the shares on the tangible elements and intervention for the protection of the heritage property are executed. The management is the final phase which will carry out all that was raised on paper, it's time to orient, explain, persuade, promote, and encourage citizens to take care of the heritage. It is profitable and also an obligation and it is not an insurmountable burden. It has to be said this is the time to pull all the cards to make the historical center and heritage becoming more alive today. It is the moment to make it more inhabited and to transformer it into a quality place, so citizens will cherish and understand the importance of such a place. Inhabited historical centers, endowments and equipment required, with trade quality, with constant cultural offer, with well-preserved buildings and tidy, modern and safe public spaces are always attractive for tourism, but first of all, the place should be conceived for citizens, otherwise everything will be doomed to failure.

Keywords: development, diagnosis, heritage historic center, intervention, management, patrimony

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Authors: T. Pradhan, P. Rijal, M. C. Regmi

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Background: Eclampsia is a multisystem disorder that involves vital organs and failure of these may lead to deterioration of maternal condition and hypoxia and acidosis of fetus resulting in high maternal and perinatal mortality and morbidity. Thus, evaluation of the contributing factors for this condition and its complications leading to maternal deaths should be the priority. Formulating the plan and protocol to decrease these losses should be our goal. Aims and Objectives: To evaluate the risk factors associated with adverse maternal and fetal outcome in patients with eclampsia and to correlate the risk factors associated with maternal and fetal morbidity and mortality. Methods: All patients with eclampsia admitted in Department of Obstetrics and Gynecology, B. P. Koirala Institute of Health Sciences were enrolled after informed consent from February 2013 to February 2014. Questions as per per-forma were asked to patients, and attendants like Antenatal clinic visits, parity, number of episodes of seizures, duration from onset of seizure to magnesium sulfate and the patients were followed as per the hospital protocol, the mode of delivery, outcome of baby, post partum maternal condition like maternal Intensive Care Unit admission, neurological impairment and mortality were noted before discharge. Statistical analysis was done using Statistical Package for the Social Sciences (SPSS 11). Mean and percentage were calculated for demographic variables. Pearson’s correlation test and chi-square test were applied to find the relation between the risk factors and the outcomes. P value less than 0.05 was considered significant. Results: There were 10,000 antenatal deliveries during the study period. Fifty-two patients with eclampsia were admitted. All of the patients were unbooked for our institute. Thirty-nine patients were antepartum eclampsia. Thirty-one patients required mechanical ventilator support. Twenty-four patients were delivered by emergency c-section and 21 babies were Low Birth Weight and there were 9 stillbirths. There was one maternal mortality and 45 patients were discharged with improvement but 3 patients had neurological impairment. Mortality was significantly related with number of seizure episodes and time interval between seizure onset and administration of magnesium sulphate. Conclusion: Early detection and management of hypertensive complicating pregnancy during antenatal clinic check up. Early hospitalization and management with magnesium sulphate for eclampsia can help to minimize the maternal and fetal adverse outcomes.

Keywords: eclampsia, maternal mortality, perinatal mortality, risk factors

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Authors: Mirka Januszkiewicz

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The Regional Municipality of Durham is the upper level of a two-tier municipal and regional structure comprised of eight lower-tier municipalities. With a population of 655,000 in both urban and rural settings, the Region is approximately 2,537 square kilometers neighboring the City of Toronto, Ontario Canada to the east. The Region has been focused on diverting waste from disposal since the development of its Long Term Waste Management Strategy Plan for 2000-2020. With a 54 percent solid waste diversion rate, the focus now is on achieving 70 percent diversion on the path to zero waste using local waste management options whenever feasible. The Region has an Integrated Waste Management System that consists of a weekly curbside collection of recyclable printed paper and packaging and source separated organics; a seasonal collection of leaf and yard waste; a bi-weekly collection of residual garbage; and twice annual collection of intact, sealed household batteries. The Region also maintains three Waste Management Facilities for residential drop-off of household hazardous waste, polystyrene, construction and demolition debris and electronics. Special collection events are scheduled in the spring, summer and fall months for reusable items, household hazardous waste, and electronics. The Region is in the final commissioning stages of an energy from the waste facility for residual waste disposal that will recover energy from non-recyclable wastes. This facility is state of the art and is equipped for installation of carbon capture technology in the future. Despite all of these diversion programs and efforts, there is still room for improvement. Recent residential waste studies revealed that over 50% of the residual waste placed at the curb that is destined for incineration could be recycled. To move towards a zero waste community, the Region is looking to more advanced technologies for extracting the maximum recycling value from residential waste. Plans are underway to develop a pre-sort facility to remove organics and recyclables from the residual waste stream, including the growing multi-residential sector. Organics would then be treated anaerobically to generate biogas and fertilizer products for beneficial use within the Region. This project could increase the Region’s diversion rate beyond 70 percent and enhance the Region’s climate change mitigation goals. Zero waste is an ambitious goal in a changing regulatory and economic environment. Decision makers must be willing to consider new and emerging technologies and embrace change to succeed.

Keywords: municipal waste, residential, waste diversion, zero waste

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Authors: Belyihun Muchie

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This study investigates the low English oral communication skills of 5 second-year English major students at Debark University. It aims to identify the key factors contributing to their weaknesses and propose effective interventions to improve their spoken English proficiency. Mixed-methods research will be employed, utilizing observations, questionnaires, and semi-structured interviews to gather data from the participants. To clearly identify these factors, structured and informal observations will be employed; the former will be used to identify their fluency, pronunciation, vocabulary use, and grammar accuracy, and the later will be suited to observe the natural interactions and communication patterns of learners in the classroom setting. The questionnaires will assess their self-perceptions of their skills, perceived barriers to fluency, and preferred learning styles. Interviews will also delve deeper into their experiences and explore specific obstacles faced in oral communication. Data analysis will involve both quantitative and qualitative responses. The structured observation and questionnaire will be analyzed quantitatively, whereas the informal observation and interview transcripts will be analyzed thematically. Findings will be used to identify the major causes of low oral communication skills, such as limited vocabulary, grammatical errors, pronunciation difficulties, or lack of confidence. They are also helpful to develop targeted solutions addressing these causes, such as intensive pronunciation practice, conversation simulations, personalized feedback, or anxiety-reduction techniques. Finally, the findings will guide designing an intervention plan for implementation during the action research phase. The study's outcomes are expected to provide valuable insights into the challenges faced by English major students in developing oral communication skills, contribute to the development of evidence-based interventions for improving spoken English proficiency in similar contexts, and offer practical recommendations for English language instructors and curriculum developers to enhance student learning outcomes. By addressing the specific needs of these students and implementing tailored interventions, this research aims to bridge the gap between theoretical knowledge and practical speaking ability, equipping them with the confidence and skills to flourish in English communication settings.

Keywords: oral communication skills, mixed-methods, evidence-based interventions, spoken English proficiency

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Authors: Joni Asitashvili, Eka Chabashvili, Maya Virsaladze, Alexander Chokhonelidze

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Studying the soundscape is a major challenge in many countries of the civilized world today. The sound environment and music itself are part of the Earth's ecosystem. Therefore, researching its positive or negative impact is important for a clean and healthy environment. The acoustics of nature gave people many musical ideas, and people enriched musical features and performance skills with the ability to imitate the surrounding sound. For example, a population surrounded by mountains invented the technique of antiphonal singing, which mimics the effect of an echo. Canadian composer Raymond Murray Schafer viewed the world as a kind of musical instrument with ever-renewing tuning. He coined the term "Soundscape" as a name of a natural environmental sound, including the sound field of the Earth. It can be said that from which the “music of nature” is constructed. In the 21st century, a new field–Ecomusicology–has emerged in the field of musical art to study the sound ecosystem and various issues related to it. Ecomusicology considers the interconnections between music, culture, and nature–According to the Aaron Allen. Eco-music is a field of ecomusicology concerning with the depiction and realization of practical processes using modern composition techniques. Finding an artificial sound source (instrumental or electronic) for the piece that will blend into the soundscape of Sound Oases. Creating a composition, which sounds in harmony with the vibrations of human, nature, environment, and micro- macrocosm as a whole; Currently, we are exploring the ambient sound of the Georgian urban and suburban environment to discover “Sound Oases" and compose Eco-music works. We called “Sound Oases" an environment with a specific sound of the ecosystem to use in the musical piece as an instrument. The most interesting examples of Eco-music are the round dances, which were already created in the BC era. In round dances people would feel the united energy. This urge to get united revealed itself in our age too, manifesting itself in a variety of social media. The virtual world, however, is not enough for a healthy interaction; we created plan of “contemporary round dance” in sound oasis, found during expedition in Georgian caves, where people interacted with cave's soundscape and eco-music, they feel each other sharing energy and listen to earth sound. This project could be considered a contemporary round dance, a long improvisation, particular type of art therapy, where everyone can participate in an artistic process. We would like to present research result of our eco-music experimental performance.

Keywords: eco-music, environment, sound, oasis

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Authors: Liu Chyong-Ru, Wang Yao-Chin, Huang Wen-Shiung, Tang Wan-Ching

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Although gamification has been concerned and applied in the tourism industry, limited literature could be found in tourism academy. Therefore, to contribute knowledge in festival gamification, it becomes essential to start by establishing a Festival Gamification Scale (FGS). This study defines festival gamification as the extent of a festival to involve game elements and game mechanisms. Based on self-determination theory, this study developed an FGS. Through the multi-study method, in study one, five FGS dimensions were sorted through literature review, followed by twelve in-depth interviews. A total of 296 statements were extracted from interviews and were later narrowed down to 33 items under six dimensions. In study two, 226 survey responses were collected from a cycling festival for exploratory factor analysis, resulting in twenty items under five dimensions. In study three, 253 survey responses were obtained from a marathon festival for confirmatory factor analysis, resulting in the final sixteen items under five dimensions. Then, results of criterion-related validity confirmed the positive effects of these five dimensions on flow experience. In study four, for examining the model extension of the developed five-dimensional 16-item FGS, which includes dimensions of relatedness, mastery, competence, fun, and narratives, cross-validation analysis was performed using 219 survey responses from a religious festival. For the tourism academy, the FGS could further be applied in other sub-fields such as destinations, theme parks, cruise trips, or resorts. The FGS serves as a starting point for examining the mechanism of festival gamification in changing tourists’ attitudes and behaviors. Future studies could work on follow-up studies of FGS by testing outcomes of festival gamification or examining moderating effects of enhancing outcomes of festival gamification. On the other hand, although the FGS has been tested in cycling, marathon, and religious festivals, the research settings are all in Taiwan. Cultural differences of FGS is another further direction for contributing knowledge in festival gamification. This study also contributes to several valuable practical implications. First, this FGS could be utilized in tourist surveys for evaluating the extent of gamification of a festival. Based on the results of the performance assessment by FGS, festival management organizations and festival planners could learn the relative scores among dimensions of FGS, and plan for future improvement of gamifying the festival. Second, the FGS could be applied in positioning a gamified festival. Festival management organizations and festival planners could firstly consider the features and types of their festival, and then gamify their festival based on investing resources in key FGS dimensions.

Keywords: festival gamification, festival tourism, scale development, self-determination theory

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Authors: Sunaitan Al Mutairi

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A perfect start is a key factor for project completion on time. The study examined the effects of delayed mobilization of resources during the initial phases of the project. This paper mainly highlights the identification and categorization of all delays during the initial construction phase and their root cause analysis with corrective/control measures for the Kuwait Oil Company oil and gas projects. A relatively good percentage of the delays identified during the project execution (Contract award to end of defects liability period) attributed to mobilization/preliminary activity delays. Data analysis demonstrated significant increase in average project delay during the last five years compared to the previous period. Contractors had delays/issues during the initial phase, which resulted in slippages and progressively increased, resulting in time and cost overrun. Delays/issues not mitigated on time during the initial phase had very high impact on project completion. Data analysis of the delays for the past five years was carried out using trend chart, scatter plot, process map, box plot, relative importance index and Pareto chart. Construction of any project inside the Gathering Centers involves complex management skills related to work force, materials, plant, machineries, new technologies etc. Delay affects completion of projects and compromises quality, schedule and budget of project deliverables. Works executed as per plan during the initial phase and start-up duration of the project construction activities resulted in minor slippages/delays in project completion. In addition, there was a good working environment between client and contractor resulting in better project execution and management. Mainly, the contractor was on the front foot in the execution of projects, which had minimum/no delays during the initial and construction period. Hence, having a perfect start during the initial construction phase shall have a positive influence on the project success. Our research paper studies each type of delay with some real example supported by statistic results and suggests mitigation measures. Detailed analysis carried out with all stakeholders based on impact and occurrence of delays to have a practical and effective outcome to mitigate the delays. The key to improvement is to have proper control measures and periodic evaluation/audit to ensure implementation of the mitigation measures. The focus of this research is to reduce the delays encountered during the initial construction phase of the project life cycle.

Keywords: construction activities delays, delay analysis for construction projects, mobilization delays, oil & gas projects delays

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Authors: B. Petrović, M. Petrović, L. Rutonjski, I. Djan, V. Ivanović

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Objective: Cardiac pacemakers are very sensitive to radiotherapy treatment from two sources: electromagnetic influence from the medical linear accelerator producing ionizing radiation- influencing electronics within the pacemaker, and the absorption of dose to the device. On the other hand, patients with cardiac pacemakers at the place of a tumor are rather rare, and single clinic hardly has experience with the management of such patients. The widely accepted international guidelines for management of radiation oncology patients recommend that these patients should be closely monitored and examined before, during and after radiotherapy treatment by cardiologist, and their device and condition followed up. The number of patients having both cancer and pacemaker, is growing every year, as both cancer incidence, as well as cardiac diseases incidence, are inevitably growing figures. Materials and methods: Female patient, age 69, was diagnozed with valvular cardiomyopathy and got implanted a pacemaker in 2005 and prosthetic mitral valve in 1993 (cancer was diagnosed in 2012). She was stable cardiologically and came to radiation therapy department with the diagnosis of right breast cancer, with the tumor in upper lateral quadrant of the right breast. Since she had all lymph nodes positive (28 in total), she had to have irradiated the supraclavicular region, as well as the breast with the tumor bed. She previously received chemotherapy, approved by the cardiologist. The patient was estimated to be with the high risk as device was within the field of irradiation, and the patient had high dependence on her pacemaker. The radiation therapy plan was conducted as 3D conformal therapy. The delineated target was breast with supraclavicular region, where the pacemaker was actually placed, with the addition of a pacemaker as organ at risk, to estimate the dose to the device and its components as recommended, and the breast. The targets received both 50 Gy in 25 fractions (where 20% of a pacemaker received 50 Gy, and 60% of a device received 40 Gy). The electrode to the heart received between 1 Gy and 50 Gy. Verification of dose planned and delivered was performed. Results: Evaluation of the patient status according to the guidelines and especially evaluation of all associated risks to the patient during treatment was done. Patient was irradiated by prescribed dose and followed up for the whole year, with no symptoms of failure of the pacemaker device during, or after treatment in follow up period. The functionality of a device was estimated to be unchanged, according to the parameters (electrode impedance and battery energy). Conclusion: Patient was closely monitored according to published guidelines during irradiation and afterwards. Pacemaker irradiated with the full dose did not show any signs of failure despite recommendations data, but in correlation with other published data.

Keywords: cardiac pacemaker, breast cancer, radiotherapy treatment planning, complications of treatment

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Authors: Jilbert Novelero, Oliver Mariano

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In a world where technological evolution and competition to create innovative products are at its peak, problems on Electronic Waste (E-Waste) are now becoming a global concern. E-waste is said to be any electrical or electronic devices that have reached the terminal of its useful life. The major issue are the volume and the raw materials used in crafting E-waste which is non-biodegradable and contains hazardous substances that are toxic to human health and the environment. The objective of this study is to gather baseline data in terms of the composition of E-waste in the solid waste stream and to determine the top 5 E-waste categories in a highly urbanized city. Recommendations in managing these wastes for its reduction were provided which may serve as a guide for acceptance and implementation in the locality. Pasig City was the chosen beneficiary of the research output and through the collaboration of the City Government of Pasig and its Solid Waste Management Office (SWMO); the researcher successfully conducted the Electronic Waste Analysis and Characterization Study (E-WACS) to achieve the objectives. E-WACS that was conducted on April 2019 showed that E-waste ranked 4th which comprises the 10.39% of the overall solid waste volume. Out of 345, 127.24kg which is the total daily domestic waste generation in the city, E-waste covers 35,858.72kg. Moreover, an average of 40 grams was determined to be the E-waste generation per person per day. The top 5 E-waste categories were then classified after the analysis. The category which ranked first is the office and telecommunications equipment that contained the 63.18% of the total generated E-waste. Second in ranking was the household appliances category with 21.13% composition. Third was the lighting devices category with 8.17%. Fourth on ranking was the consumer electronics and batteries category which was composed of 5.97% and fifth was the wires and cables category where it comprised the 1.41% of the average generated E-waste samples. One of the recommendations provided in this research is the implementation of the Pasig City Waste Advantage Card. The card can be used as a privilege card and earned points can be converted to avail of and enjoy services such as haircut, massage, dental services, medical check-up, and etc. Another recommendation raised is for the LGU to encourage a communication or dialogue with the technology and electronics manufacturers and distributors and international and local companies to plan the retrieval and disposal of the E-wastes in accordance with the Extended Producer Responsibility (EPR) policy where producers are given significant responsibilities for the treatment and disposal of post-consumer products.

Keywords: E-waste, E-WACS, E-waste characterization, electronic waste, electronic waste analysis

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Authors: Jiahao Tian, Michael D. Porter

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Law enforcement agencies are tasked with crime prevention and crime reduction under limited resources. Having an accurate temporal estimate of the crime rate would be valuable to achieve such a goal. However, estimation is usually complicated by the interval-censored nature of crime data. We cast the problem of intensity estimation as a Poisson regression using an EM algorithm to estimate the parameters. Two special penalties are added that provide smoothness over the time of day and day of the week. This approach presented here provides accurate intensity estimates and can also uncover day-of-week clusters that share the same intensity patterns. Anticipating where and when crimes might occur is a key element to successful policing strategies. However, this task is complicated by the presence of interval-censored data. The censored data refers to the type of data that the event time is only known to lie within an interval instead of being observed exactly. This type of data is prevailing in the field of criminology because of the absence of victims for certain types of crime. Despite its importance, the research in temporal analysis of crime has lagged behind the spatial component. Inspired by the success of solving crime-related problems with a statistical approach, we propose a statistical model for the temporal intensity estimation of crime with censored data. The model is built on Poisson regression and has special penalty terms added to the likelihood. An EM algorithm was derived to obtain maximum likelihood estimates, and the resulting model shows superior performance to the competing model. Our research is in line with the smart policing initiative (SPI) proposed by the Bureau Justice of Assistance (BJA) as an effort to support law enforcement agencies in building evidence-based, data-driven law enforcement tactics. The goal is to identify strategic approaches that are effective in crime prevention and reduction. In our case, we allow agencies to deploy their resources for a relatively short period of time to achieve the maximum level of crime reduction. By analyzing a particular area within cities where data are available, our proposed approach could not only provide an accurate estimate of intensities for the time unit considered but a time-variation crime incidence pattern. Both will be helpful in the allocation of limited resources by either improving the existing patrol plan with the understanding of the discovery of the day of week cluster or supporting extra resources available.

Keywords: cluster detection, EM algorithm, interval censoring, intensity estimation

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Authors: Gulden Aykinbaeva, Assem Umirzakova, Assel Makhadiyeva

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The problem of studying of young married couples in connection with a change of social institute of a family and marriage is represented very actual for family consultation, considering a family role in the development of modern society. Results of numerous researchs say that one of difficult in formation and stabilization of a matrimony is the period of a young family. This period is characterized by various processes of integration, adaptation and emotional compatibility of spouses. The young family in it the period endures the first standard crisis which postpones a print for the further development of the family scenario. Emergence new, earlier not existing, systems of values render a huge value on the process of formation of a young family and each of spouses separately. Possibly to solve the set family tasks at the development of the uniform system of the family relations in which socially mature persons capable to consider a family as the creativity of each other act as subjects. Due to the research objective in work the following techniques were used: a questionnaire of satisfaction with V. V. Stolin's marriage and A. N. Volkova's technique directed on detection of coherence of family values and role installations in a married couple, and also content – the analysis. Development of an internal basis of a family on mutual clearing of values is important during the work with married couples. 'The mature view' of the partner in the marriage union provides coherence between the expected and real behavior of the partner that is important for the realization of the purposes of adaptation in a family. For research of communication of the data obtained by means of A. N. Volkova's techniques, V. V. Stolina and content – the analysis, the correlation analysis, with the application of the criterion of Spirmen was used. The analysis of results of the conducted research allowed us to determine the number of consistent patterns: 1. Nature of change of satisfaction with marriage at spouses testifies that the matrimonial relations undergo high-quality changes at different stages of formation of a young family. 2. The matrimonial relations in the course of their development, formation and functioning in young marriage undergo considerable changes on psychological, social and psychological and insignificant — at the psychophysiological and sociocultural levels. The material received by us allows to plan ways of further detailed researches of the development of the matrimonial relations not only in the young marriage but also at further stages of development of a matrimony. We believe that the results received in this research can be almost applied at creation of algorithms of selection of marriage partners, at diagnostics of character and the maintenance of matrimonial disharmonies, at the forecast of stability of marriage and a family.

Keywords: married couples, formation of the young family, psychological consultation, matrimony

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Authors: Christine Winberg, James Garraway

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Many key university documents, such as vision and mission statements and strategic plans, are aspirational and future-oriented. There is a wide range of future-oriented methods that are used in planning applications, ranging from mathematical modelling to expert opinions. Many of these methods have limitations, and planners using these tools might, for example, make the technical-rational assumption that their plans will unfold in a logical and inevitable fashion, thus underestimating the many complex forces that are at play in planning for an unknown future. This is the issue that this study addresses. The overall project aim was to assist a new university of technology in developing appropriate responses to its social responsibility, graduate employability and research missions in its strategic plan. The specific research question guiding the research activities and approach was: how might the use of innovative future-oriented planning tools enable or constrain a strategic planning process? The research objective was to engage collaborating groups in the use of an innovative tool to develop and assess future scenarios, for the purpose of developing deeper understandings of possible futures and their challenges. The scenario planning tool chosen was ‘fictive scripting’, an analytical technique derived from Technology Forecasting and Innovation Studies. Fictive scripts are future projections that also take into account the present shape of the world and current developments. The process thus began with a critical diagnosis of the present, highlighting its tensions and frictions. The collaborative groups then developed fictive scripts, each group producing a future scenario that foregrounded different institutional missions, their implications and possible consequences. The scripts were analyzed with a view to identifying their potential contribution to the university’s strategic planning exercise. The unfolding fictive scripts revealed a number of insights in terms of unexpected benefits, unexpected challenges, and unexpected consequences. These insights were not evident in previous strategic planning exercises. The contribution that this study offers is to show how better choices can be made and potential pitfalls avoided through a systematic foresight exercise. When universities develop strategic planning documents, they are looking into the future. In this paper it is argued that the use of appropriate tools for future-oriented exercises, can help planners to understand more fully what achieving desired outcomes might entail, what challenges might be encountered, and what unexpected consequences might ensue.

Keywords: fictive scripts, scenarios, strategic planning, technological forecasting

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Authors: Lily Farris, Chantel E. Canessa, Rena Heathcote, Susan Shumay, Suzanna V. McRae, Alissa Collingridge, Minna K. Miller

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Objective: To describe how the Lean approach can be applied to improve access, quality and safety of care in an ambulatory pediatric primary care setting. Background: Lean was originally developed by Toyota manufacturing in Japan, and subsequently adapted for use in the healthcare sector. Lean is a systematic approach, focused on identifying and reducing waste within organizational processes, improving patient-centered care and efficiency. Limited literature is available on the implementation of the Lean methodologies in a pediatric ambulatory care setting. Methods: A strategic continuous improvement event or Rapid Process Improvement Workshop (RPIW) was launched with the aim evaluating and structurally supporting clinic workflow, capacity building, sustainability, and ultimately improving access to care and enhancing the patient experience. The Lean process consists of five specific activities: Current state/process assessment (value stream map); development of a future state map (value stream map after waste reduction); identification, quantification and prioritization of the process improvement opportunities; implementation and evaluation of process changes; and audits to sustain the gains. Staff engagement is a critical component of the Lean process. Results: Through the implementation of the RPIW and shifting workload among the administrative team, four hours of wasted time moving between desks and doing work was eliminated from the Administrative Clerks role. To streamline clinic flow, the Nursing Assistants completed patient measurements and vitals for Nurse Practitioners, reducing patient wait times and adding value to the patients visit with the Nurse Practitioners. Additionally, through the Nurse Practitioners engagement in the Lean processes a need was recognized to articulate clinic vision, mission and the alignment of NP role and scope of practice with the agency and Ministry of Health strategic plan. Conclusions: Continuous improvement work in the Pediatric Primary Care NP Clinic has provided a unique opportunity to improve the quality of care delivered and has facilitated further alignment of the daily continuous improvement work with the strategic priorities of the Ministry of Health.

Keywords: ambulatory care, lean, pediatric primary care, system efficiency

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Authors: Aisha Giwa, Mohammed-Faosy Adeniran, Olufunke Femi-Ojo

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Four decades ago, the World Health Organization (WHO) launched the Expanded Programme on Immunization (EPI). The EPI blueprint laid out the technical and managerial functions necessary to routinely vaccinate children with a limited number of vaccines, providing protection against diphtheria, tetanus, whooping cough, measles, polio, and tuberculosis, and to prevent maternal and neonatal tetanus by vaccinating women of childbearing age with tetanus toxoid. Despite global efforts, the Routine Immunization (RI) coverage in two of the World Health Organization (WHO) regions; the African Region and the South-East Asia Region, still remains short of its targets. As a result, the WHO Regional Director for Africa declared 2012 as the year for intensifying RI in these regions and this also coincided with the declaration of polio as a programmatic emergency by the WHO Executive Board. In order to intensify routine immunization, the National Routine Immunization Strategic Plan (2013-2015) stated that its core priority is to ensure 100% adequacy and availability of vaccines for safe immunization. To achieve 100% availability, the “PUSH System” and then “Push-Plus” were adopted for vaccine distribution, which replaced the inefficient “PULL” method. The NPHCDA plays the key role in coordinating activities in area advocacy, capacity building, engagement of 3PL for the state as well as monitoring and evaluation of the vaccine delivery process. eHealth Africa (eHA) is a player as a 3PL service provider engaged by State Primary Health Care Boards (SPHCDB) to ensure vaccine availability through Vaccine Direct Delivery (VDD) project which is essential to successful routine immunization services. The VDD project ensures the availability and adequate supply of high-quality vaccines and immunization-related materials to last-mile facilities. eHA’s commitment to the VDD project saw the need for an assessment of the project vis-a-vis the overall project performance, evaluation of a process for necessary improvement suggestions as well as general impact across Kano State (Where eHA had transitioned to the state), Bauchi State (currently manage delivery to all LGAs except 3 LGAs currently being managed by the state), Sokoto State (eHA currently covers all LGAs) and Zamfara State (Currently, in-sourced and managed solely by the state).

Keywords: cold chain logistics, health supply chain system strengthening, logistics management information system, vaccine delivery traceability and accountability

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Authors: Manal Anis, Bin Bakhti Sayeed

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With the encroachment of automobile upon our communities for decades and the concomitant urban sprawl resulting in a loss of public place, it was only a matter of time before people, realizing the role of streets in stimulating urban prosperity, would start reclaiming them to rebuild their communities. In order for this restoration of communities to take effect it is imperative that streets be freed from the dominance of motor vehicles. A holistic approach to pedestrian-friendly street environment can help build communities that embody the cities in which they are found. While the developed countries are finding more and more innovative ways to integrate walkable streets to foster communal living, the developing countries still have a long way to go. Since Dhaka is still struggling to balance the growing needs of accommodating automobiles for increased population with the loss of urban community life that comes with it, it is high time that alternate approaches are looked into. This study aims to understand streets as a living corridor through which one discovers and identifies with the city. The research area is chosen to be Manik Mia Avenue, overlooking the South Plaza of the National Parliament Building in Dhaka city. Being the site of supreme power, it is precisely this symbolic importance that the National Parliament Building has in the psyche of Bangladeshis, which has given Manik Mia Avenue a significant place in the country’s history. Above all, being an avenue it is essentially a neutral territory, universally accessible, inclusive and pluralist. The needs of the Avenue’s frequent users are analyzed with the help of a multi-method approach to survey consisting of an empirical study, a questionnaire survey and interview with relevant users. The research then tries to understand the concept of walkability by exploring the different ways in which the built environment influences walking. For this analysis, the six dimensions of Matthew Carmona are taken as a guideline for a holistic approach toward the different interacting facets of an urban public space. Based on the studies, a set of criteria is proposed to evaluate, plan and design streets that are more contextual in nature. The study concludes with how the existing street patterns of Dhaka city can be rethought and redesigned to cater to peoples’ need for a public place. The proposal is meant to be an inspiration for further studies in this respect in the context of Bangladesh.

Keywords: public space, six dimensions, street, urban, walkability

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Authors: Yang Chen, Lili Fu

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Promoting urban regeneration in existing areas has been elevated to a national strategy in China. In this context, because of the multidimensional sustainable effect through the intensive use of land, mixed-use development has become an important objective for high-quality urban regeneration in the inner city. However, in the long period of time since China's reform and opening up, the "unbalanced phenomenon" of mixed-use development in China's inner cities has been very serious. On the one hand, the excessive focus on certain individual spaces has led to an increase in the level of mixed-use development in some areas, substantially ahead of others, resulting in a growing gap between different parts of the inner city; On the other hand, the excessive focus on a one-dimensional element of the spatial organization of mixed-use development, such as the enhancement of functional mix or spatial capacity, has led to a lagging phenomenon or neglect in the construction of other dimensional elements, such as pedestrian permeability, green environmental quality, social inclusion, etc. This phenomenon is particularly evident in the central area of the inner city, and it clearly runs counter to the need for sustainable development in China's new era. Therefore, a rational qualitative and quantitative analysis of the "unbalanced phenomenon" will help to identify the problem and provide a basis for the formulation of relevant optimization plans in the future. This paper builds a dynamic evaluation method of mixed-use development based on a meta-dimensional model and then uses spatial evolution analysis and spatial consistency analysis with ArcGIS software to reveal the "unbalanced phenomenon " in over the past 40 years of the central city area in Nanjing, a China’s typical city facing regeneration. This study result finds that, compared to the increase in functional mix and capacity, the dimensions of residential space mix, public service facility mix, pedestrian permeability, and greenness in Nanjing's city central area showed different degrees of lagging improvement, and the unbalanced development problems in each part of the city center are different, so the governance and planning plan for future mixed-use development needs to fully address these problems. The research methodology of this paper provides a tool for comprehensive dynamic identification of mixed-use development level’s change, and the results deepen the knowledge of the evolution of mixed-use development patterns in China’s inner cities and provide a reference basis for future regeneration practices.

Keywords: mixed-use development, unbalanced phenomenon, the meta-dimensional model, over the past 40 years of Nanjing, China

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Authors: Reshma Parvin Nuri, Heather Michelle Aldersey, Setareh Ghahari

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Objectives: Worldwide, it is well known that taking care of children with disabilities (CWD) can have a significant impact on the entire family unit. Over the last few decades, an increased number of studies have been conducted on families of CWD in higher income countries, and much of this research has identified family needs and strategies to meet those needs. However, family needs are incredibly under-studied in developing countries. Therefore, the aims of this study were to: (a) explore the needs of families of children with cerebral palsy (CP) in Bangladesh; (b) investigate how some of the family needs have been met and (c) identify the sources of supports that might help the families to meet their needs in the future. Methods: A face to face, semi-structured in-depth interview was conducted with 20 family members (12 mothers, 4 fathers, 1 sister, 2 grandmothers, and 1 aunt) who visited the Centre for the Rehabilitation of the Paralysed (CRP), Bangladesh between June and August 2016. Constant comparison method of grounded theory approach within the broader spectrum of qualitative study was used to analyze the data. Results: Participants identified five categories of needs: (a) financial needs, (b) access to disability-related services, (c) family and community cohesion, (d) informational needs, and (e) emotional needs. Participants overwhelmingly reported that financial need is their greatest family need. Participants noted that families encountered additional financial expenses for a child with CP, beyond what they would typically pay for their other children. Participants were seeing education as their non-primary need as they had no hope that their children would be physically able to go to school. Some participants also shared their needs for social inclusion and participation and receiving emotional support. Participants further expressed needs to receive information related to the child’s health condition and availability/accessibility of governmental support programs. Besides unmet needs, participants also highlighted that some of their needs have been met through formal and informal support systems. Formal support systems were mainly institution-based and run by non-governmental organizations, whereas participants identified informal support coming from family, friends and community members. Participants overwhelmingly reported that they receive little to no support from the government. However, participants identified the government as the key stakeholder who can play vital role in meeting their unmet needs. Conclusions: In the next phase of this research, the plan is to understand how the Government of the People’s Republic of Bangladesh is working to meet the needs of families of CWD. There is also need for further study on needs of families of children with conditions other than CP and those who live in the community and do not have access to the CRP Services. There is clear need to investigate ways to enable children with CP have better access to education in Bangladesh.

Keywords: Bangladesh, children with cerebral palsy, family needs, support

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Authors: Domenica Bona

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Colin Chant and David Goodman argue that historians of Chinese pre-industrial cities tend to underestimate revolutions and overestimate cyclic patterns: periods of peace and prosperity in the earl part of each d nast , followed b peasants’ rebellions and upheavals. Boyd described these cyclic patterns as part of the background of Chinese town planning and architecture. Thus old ideals of city planning-square plan, southward orientation and a palace along the central axis - are revived again and again in the ascendant phases of several d nastic c cles (e.g. Chang’an, Kaifen, and Beijing). Along this line of thought, m paper questions the relationship between the “magic square rule” and modern Chinese urban- planning. As a matter of fact, the classical theme of “cosmic Taoist urbanism” is still a reference for planning cities and new urban developments, whenever there is the intention to express nationalist ideals and “cultural straightforwardness.” Besides, some case studies can be related to “modern d nasties”: the first Republic under the Kuo Min Tang, the red People’s Republic and the post-Maoist open country of Deng Xiao Ping. Considering the project for the new capital of Nanjing in the Thirties, Beijing’s Tianan Men area in the ifties, and Shenzhen’s utian CBD in late 20th century, I argue that cyclic patterns are still in place, though with deformations related to westernization, private interests and lack of spirituality. How far new Chinese cities are - or simply seem to be - westernized? Symbolism, invisible frameworks, repeating features and behavioural patterns make urban China just “superficiall” western. This can be well noticed in cities previousl occupied b foreigners, like Hong Kong, or in newly founded ones, like Shenzhen, where both Asians and non-Asian people can feel the gender-shift from New-York-like landscapes to something else. Current planning in main metropolitan areas shows a blurred relationship between public policies and private investments: two levels of decisions and actions, one addressing the larger scale and infrastructures, the other concerning the micro scale and development of single plots. While zoning is instrumental in this process, master plans are often laid out over a very poor cartography, so much that any relation between the formal characters of new cities and the centuries-old structure of the related territory gets lost.

Keywords: China, contemporary cities, cultural heritage, shenzhen, urban planning

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Authors: Fatemeh Moosavi, Tumelo Franck Nkoshwane

Abstract:

Peter Drucker the renowned management guru once said, “The best way to predict the future is to create it.” Mr. Drucker is also the man who placed human capital as the most vital resource of any institution. As such any institution bent on creating a better future, requires a competent human capital, one that is able to execute with efficiency and effectiveness the objective a society aspires to. Technology today is accelerating the rate at which many societies transition to knowledge based societies. In this accelerated paradigm, it is imperative that those in leadership establish a platform capable of sustaining the planned future; intellectual capital. The capitalist economy going into the future will not just be sustained by dollars and cents, but by individuals who possess the creativity to enterprise, innovate and create wealth from ideas. This calls for cities of the future, to have this premise at the heart of their future plan, if the objective of designing sustainable and liveable future cities will be realised. The knowledge economy, now transitioning to the creative economy, requires cities of the future to be ‘gardens’ of inspiration, to be places where knowledge, creativity, and innovation can thrive as these instruments are becoming critical assets for creating wealth in the new economic system. Developing nations must accept that learning is a lifelong process that requires keeping abreast with change and should invest in teaching people how to keep learning. The need to continuously update one’s knowledge, turn these cities into vibrant societies, where new ideas create knowledge and in turn enriches the quality of life of the residents. Cities of the future must have as one of their objectives, the ability to motivate their citizens to learn, share knowledge, evaluate the knowledge and use it to create wealth for a just society. The five functional factors suggested by Kevin Lynch;-vitality, meaning/sense, adaptability, access, control, and monitoring should form the basis on which policy makers and urban designers base their plans for future cities. The authors of this paper believe that developing nations “creative economy clusters”, cities where creative industries drive the need for constant new knowledge creating sustainable learning creative cities. Obviously the form, shape and size of these districts should be cognisant of the environmental, cultural and economic characteristics of each locale. Gaborone city in the republic of Botswana is presented as the case study for this paper.

Keywords: learning city, sustainable creative city, creative industry, good city form

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